Clamp for retaining the edges of a wound in apposition



March 20, 1945. R. G. PERHAM 2,371,978

: CLAMP FOR RETAINING THE EDGES OF A WOUND IN APPOSITION Filed Dec. 13,1941 3 Sheets-Sheet 1 &\\\\\\\\\\\\\ INVENTOR. R0 Y PEKHA m ifl/ug PMATTORNEYS R. s. PERHAM 2,371,978

CLAMP FOR RETAINING THE EDGES OF A WOUND IN APPOSITION M ch 20, 1945.

Filed Dec. 13, 1941. 3 Sheets-Sheet 2 INVENTOR. Y Pay 6. PERHAMATTOR/YEYS R. G. PERHAM March 20, 1945.

CLAMP FOR RETAINING THE EDGES OF A WOUND IN APPOSITION Filed Dec. 13,1941 3 SheetsSheet 3 I N V EN TOR. F0 y 6, Ff/PHHM Patented Mar. 20,1945 CLAMP FOR RETAINING THE EDGES WOUND IN APPOSII ION Roy G. Pei-ham,-Hasbrouck Heights, N. J. Application December 13, 1941,;Serial No.422.885 7 2 Claims. (01. 1284-335) This invention i for a means fordrawing and retaining the opposite edges of the layers of the skin andsubcutaneous tissue of a wound crincision in apposition 01' in impingingrelation so as to effect a more rapid healing thereof and to relieve thelower muscle from strain or stress.

The general practice of employing sutures or skin piercing clamps fordrawing the opposite sides of a wound or incision together ha been foundobjectionable. since the same draw the edges of the wound or incisiontogether at spaced intervals onlyand permits the wound orincision toseparate between the stitches or prongs of the clamp, while thepuncturing of the skin renders it susceptible to local infection.Furthermore, the subcutaneous fatty tissue has a tendency to recede fromthe wound or incision due to the fact that such tissuefcannot be heldtogether by surface sutures or clamps and no means other than bindingsis provided for preventing strain or stress on sutured lower muscleswhich often results in rupture due to coughing or vomiting.

The present invention, therefore, provides an improved clamp or surgicalappliance for drawing areas of the skin on opposite sides of a wound, orincision towards each other to form an upstanding ridge between saidareas to thereby dispose the edges of the skin and subcutaneous tissueon opposite sides of the wound or incision in apposition continuouslythroughout the extent thereof and with the wound or incision disposedlongitudinally oi the upstanding ridge and substantially at the centerthereof and for drawin lateral areas of the skin on opposite sides ofsaid first mentioned areas towards each other to form a relativelylarger upstanding ridge or bulge between said lateral areas so as todispose the first mentioned ridge longitudinally ofthe said larger ridgeand substantially at the center thereof for preventing transmission ofstrains or stresses to the wound or incision and the lower suturedmuscles. r

The invention is further directed to surgical appliances having spacedparallel bars joined tov gather by bowed bridge members and havingadhesive strips carried by the bars for attaching the appliance inposition with the bars disposed on opposite sides of a wound or incisionso as to draw the opposite sides thereof outwardly into ridge formationwith the edges of the woundor incision in continuous apposition. I

With the foregoing and other objects in view, reference is now madetothe following specification and accompanying drawings in which clampsemployed in carrying out there is illustrated the preferred forms of theappliances for carrying out themethod. f

In the drawings: I v Fig. 1 is a perspective view of one of thesrnailerthe invention; ig'. 2 is a similar view thereof strips applied thereto.M Fig. 3 is a' transverse sectional view of a large and small clampillustrating the same in applied position with reference to a wound orincision.

Fig. 4 is a perspective view oi large and small clamps in appliedposition and illustrating a modi fied form of large clamp. f

Fig; 5 is a transverse'sectional view there'- through. H v

Figs. 6, 7, 8 and 9, are perspective views of modifled 'forms of smallerclamps with the adhesive tape omitted.

'Fig. 1015 a perspective view of the largeand small clamps illustratedin Figs. 4 and 5 of the drawings, the large clamp being Provided withamodified form of auxiliaryadhesive strip.

- Fig. 11 is a perspective view of the clamp 'il-' lustrated in Figs. 4,5 and 10 with the adhesive strips removed. "Referring to the drawings bycharacters, of reference and more particularly to the form of theinvention illustrated in Figs. 1 to 3 of the drawings, the clampindicated generally by the reference character A is adapted to beadhesively' secured to areas B and C of the skin on opposite sides of awound or incision D to. thereby form an upstanding ridge E between theareas B and C and to draw the opposite edges of the wound or incisiontogether to dispose the same in continuous apposition.

"As illustrated in Fig. 3 of the drawings the edges of the outer layer Fof the skin on opposite sides of the wound or incision D are compressedtogether continuously throughout the extent of the wound or incision soas to close the same. l'he 1 edge of the inner layer G of the skin onopposite sides of the wound or incision ar likewise com pressed to etherin continuous apposition and since this layer of the skin contains bloodvessels, the sameg'row together more rapidly when firmly held togetherin continuous apposition.

A relatively large clamp H may also beemployed which is'adapted to beadhesively secured to areas J and K of the skinon ppposite sides of'thew'ound or incision and laterally of the areas B and C. In applyingthe clamp H to the skin, the areas J and K are drawn towards each otherso as to form a relatively larger upstand ing ridge or bulge L of theskin and subcutaneous with the. adhesive tissue between the areas J andK and within which ridge or bulg the wound or incision D is disposedlongitudinally and substantially at the center thereof. The drawing ofthe spaced areas J and K inwardly toward each other into the upstandingridge or bulge L produces a slackness on opposite sides of the wound orincision for preventing transmission of strains or stresses of themuscles to the wound or incision.

The clamps A and H are of substantially similar construction and eachincludes'longitudinally extending bars ID which are connected togetherin spaced parallel relation by bridge elements each consisting of anarcuate bight portion H minals of which are connected with the bars lpreferably at theends thereof. "Theba-rs Ill each carries an adhesivestrip l3 which embraces the,

The strips l3 may consist of either single or double faced adhesivematerial, the .outer adhesivefaces of whichare covered bystrips of gauzel4 and to maintain the same in an antiseptic condition until the same isto be used when the gauze strip I5 is removed to expose the freshadhesive.

The .clamps are composed of deformable .material such as malleable .oruntempered steel or iron, synthetic plastic compositions or any otherequivalent material which possesses .thecharacter or quality ofretaining afixed shape or formation against distortion under any usualstrain or stress to which the clamp is subjected when in use, whilepermitting of .the manual bending of the bridge elementsor legs ltowardseach other when adhesively secured in applied position. When the legs I2of the smaller clamps are thus bent from outwardly divergent relation.as illustrated in Figs. .1 and 2 of the drawings to inwardly bowedformation, as illustrated in Fig. 3 thereof, the bars 10 are compressedagainst the opposite sides .of the ridge or bulge to retain the edges ofthe wound or incision in apposition. This inward bending of the legs maybe periodically effected .during the healing of the wound or incision.

In use, theclampais first applied :by securing one of th adhesive-stripsl3'thereof to the area of the skin B longitudinally and at one side ofthe woundor incision Dafter which the opposite strip of adhesive isapplied to the area C on the oppositeside of the wound or incision D,while drawing the .areas B and C of the skin together into ridgeformation. When in applied position, the legs l2 are pressed inwardly ortowards each otherto thereby provide the desired compression on theopposite sides of the ridge E to dispose the edges of the skin .andsubcutaneous tissue .on opposite sides of the wound or incision incontinuous apposition throughout the extent thereof. The large clamp .His .applied in a similar .manner in .straddling relation with th clamp Aso as to provide the. upstanding ridge or bulge L .between the bars inthereof and with the wound or incision D disposed lqngitudinally of andsubstantially at thecenter thereon.

A .clampsuch as illustrated in Figs. 4 and 50f the drawings may .beemployed for retaining in continuous pposition during healing theopposite edgeslof a wound or incision which is located in the walls ofthe abdomen or other parts of the body having fatty tissue between theskin and muscles: .As shown therein the clamp M maybe employed inaddition to the clamp A which is secured to the areas B and C of theskin on opposite sides of the wound or incision D to form the upstandingridge E as hereinbefore described.

The clamp M is disposed in straddling relation to the clamp A and isadhesively secured to areas N and O of the skin on opposite sides of thewound or incision D and laterally of the areas B and C. The clamp isthus applied to draw the areas N'and O of the skin towards eachother soas'to form the upstanding ridge or bulge P between the areas N and O andwithin which ridge or bulge P the clamp A and wound or incision D arelocated longitudinally and substantially at the .center .thereof. Theridge or bulge P is of a height that the fatty tissue and muscleslocated between the areas N and O are likewise bulged outwardly. The:slackness produced by the bulge P extends into the muscles Q to therebyrelieve strains or stresses from the sutures so as to prevent rupturethereof which frequently happens due to coughing or vomiting. The fattytissuelit on opposite sides of the wound or incision is also drawntogether to thereby close the wound or incision between theskin andmuscles and to .cover and protect the sutures in the muscles.

The clamp M consists of longitudinally extending .bars H which areconnected together in tively at the ends thereof. The said bridgeelements are connected together at the juncture of the medial portions88 with the bowed end portions H? by longitudinallyextending parallelbars 20. The bars .11 each carries an adhesive strip which embraces thesame and is doubled upon itself to provide a two ply thickness with theupper ply 2| secured upon the lower Iply .22 by any desired means,,thelower ply 22 being adapted to be adhesively secured to the areas .Nand Obi theskin as hereinbefore described.

The bars 20 may each be similarly provided an auxiliary adhesive strip.23 which embraces the said bars and is secured tothe lower ply as at 24in any desired manner and which lower .ply is.

adapted to be secured to the skin at the areas S and T as illustrated inFigs. 4 and 5.

the body inorder-to assist the adhesive strips22 for maintaining theelampinposition.

In place .of the clamp A employed in -.carry.ing out the invention asillustrated intheforms hereinbefore described, the same maybe inthe formof theclamps U, V, Wand Xshown in Eigs. 6=to,9' inclusive ofthefdrawings. .As illustrated in Rig 6, the longitudinally extendingbars 25;,of the clamp 13 are iongitudinallycurved to providelongitudinally extending concave bottom edges 36.

adapted to bearrangedin. straddling relation with a wound .or incisionin a :convex body.

formation, while in Fig. .8 the longitudinally extending bars 31 ofthe.clamp- W are curved .orlaterally offset intermediate their length ina ny;

These. strips .23 function to draw .the clamp M towards portion of the.

desired manner so as to coincide with the contour of wound-s orincisions of irregular shape.

The clamp X illustrated in Fig. 9 of the drawings, is of relativelyshorter length having the opposite bars 33 parallel and provided withthe upwardly projecting lugs 34 for facilitating the grasping thereof,it being understood that the said bars in the clamps illustrated inFigs. 6 1:09 inclusive are provided with adhesive strips similar to thstrips l3 for securing the same in position with the areas of the skin Band C.

In treating certain wounds orincisions it is desirable to provide meansfor periodically increasing the lateral pressure at the opposite sidesof the longitudinally extending ridge or bulge P formed by the largeclamp M. This may be effected by providing the clamp M with auxiliaryadhesive strips which are adjustable to shorten their overall length. I

As illustrated in Fig. 11, the clamp M is similar to the construction ofthe large clamp M shown in Figs; 4 and 5 of the drawings, and isprovided with auxiliary strips 36 each consisting of sec tions 31 and38, the formerbeing attached to a bar 20 of the clamp, while the latteris adapted to be adhesively secured to the skin as at S and T. Thesections 31 and 38 are provided with tie strings 39 and 40 adapted to betied together for exerting outward tension on the bars 20 at theopposite ends of the clamp to thereby efiect a drawing of the clamptowards the body and the inward tightening of the bars I! against theopposite sides of the ridge or bulge P. I

The clamps H and M may also be used independently of the small clamp Aor the clamps U, V, W and X for gangrenous or sloughing wounds orincisions. When thus used, the opposite edges of the wound or incisionare maintained in open relation so as to permit of drainage. The legs l2of the clamp H and the bowed end portions IQ of, the clamp M beingdeformable, the same may be progressively advanced towards each other toincrease the pressure from day to day thus forcing the opposite edges ofthe skin and subcutaneous tissue gradually together as the cleansing andgranulations of the wounds or incisions progress.

What is claimed is:

1. A surgical clamp consisting of longitudinally extending bars, bridgeelements connecting the same together and each including a transverselyextending elevated medial portion and oppositely disposed confrontingbowed end portions having their inwardly directed terminals connectedwith the bars respectively at the ends thereof, and longitudinallyextending bars connecting the bridge elements at the juncture of saidmedial and bowed end portions and adhesive strips carried'by all of saidbars to project laterally therefrom and adapted to be adhesively securedto the skin on opposite sides of an incision for producing an elevationof the skin and subcutaneous tissue on opposite sides of theincision;

2. A surgical clamp consisting of longitudinally extending bars, bridgeelements connecting the same together at the opposite ends thereof, saidbridge elements each including a transversely extending elevated medialportion, oppositely disposed confronting bowed end portions having theirinwardly directed terminals connected with i ments of the clamp at theopposite ends thereof.

ROY G. PERI-1AM-

